The most thorough and well controlled study of the effect of ivermectin on Covid-19 was just published in the Journal of Internal Medicine. The drug ivermectin does not prevent or cure covid-19, as the FDA asserts. The study shows that Ivermectin doesn't help people who are hospitalized for the virus get better.
Every well controlled study shows that ivermectin is useless once you get the virus. There was no good evidence that ivermectin prevented infections in the studies that included prevention. The drug may help you get rid of worms and make you more likely to recover from covid. You wouldn't take ivermectin if you had worms.
Ivermectin is used in humans to cure parasites, but can be dangerous if taken in high amounts. Even though it's beyond doubt that the vaccines prevent severe illness and hospitalization, even credentialed scientists like the Weinsteins have recommended Ivermectin and criticized vaccines. You would have to be crazy or paranoid to pass up vaccine in favor of ivermectin.
You should be able to get the new study if you have the legal Unpaywall app. If all else fails, make a careful inquiry because there is a link to the PDF.
The authors summarize what they know about Ivermectin. I and others have said that before.
Although some early clinical studies suggested the potential efficacy of ivermectin in the treatment and prevention of COVID-19, these studies had methodologic weaknesses. In 2021, 2 randomized clinical trials from Colombia and Argentina found no significant effect of ivermectin on symptom resolution and hospitalization rates for patients with COVID-19. A Cochrane meta-analysis also found insufficient evidence to support the use of ivermectin for the treatment or prevention of COVID-19. [JAC: The meta-analysis is linked above.]
There was no placebo control in the new study, which wasrandomized with respect to patient condition and age. Half of the patients were given standard of care and the other half were given Ivermectin. Ivermectin did not work, but there was a slightly higher risk of patients progressing to the phase that required supplemental oxygen. If there is a placebo effect, then placebo-ingesting patients would do better than those not taking placebos. There was no effect of ivermectin on disease progression in this study despite the absence of placebos.
The results will not be summarized in detail because the authors do a good job of that.
There are three summaries. The first version is the.
The 490 patients observed were all over 50 and had documented comorbidities that make them more susceptible to death.
The Ivermectin Treatment Efficacy in COVID-19 High-Risk Patients (I-TECH) study was an open-label randomized clinical trial conducted at 20 public hospitals and a COVID-19 quarantine center in Malaysia between May 31 and October 25, 2021. Within the first week of patients’ symptom onset, the study enrolled patients 50 years and older with laboratory-confirmed COVID-19, comorbidities, and mild to moderate disease.
Interventions Patients were randomized in a 1:1 ratio to receive either oral ivermectin, 0.4 mg/kg body weight daily for 5 days, plus standard of care (n = 241) or standard of care alone (n = 249). The standard of care consisted of symptomatic therapy and monitoring for signs of early deterioration based on clinical findings, laboratory test results, and chest imaging.
No placebo pills were given. They measured outcome here.
Main Outcomes and Measures The primary outcome was the proportion of patients who progressed to severe disease, defined as the hypoxic stage requiring supplemental oxygen to maintain pulse oximetry oxygen saturation of 95% or higher. Secondary outcomes of the trial included the rates of mechanical ventilation, intensive care unit admission, 28-day in-hospital mortality, and adverse events.
Below are the results. Patients in the ivermectin-dosed group progressed to severe disease 4% more than those in the group without ivermectin. There was no significant difference between the two groups, although there was slightly more deaths in the ivermectin group. I can't find the statistics for the difference between the ivermectin and control groups when it comes to side effects.
Results Among 490 patients included in the primary analysis (mean [SD] age, 62.5 [8.7] years; 267 women [54.5%]), 52 of 241 patients (21.6%) in the ivermectin group and 43 of 249 patients (17.3%) in the control group progressed to severe disease (relative risk [RR], 1.25; 95% CI, 0.87-1.80; P = .25). For all prespecified secondary outcomes, there were no significant differences between groups. Mechanical ventilation occurred in 4 (1.7%) vs 10 (4.0%) (RR, 0.41; 95% CI, 0.13-1.30; P = .17), intensive care unit admission in 6 (2.4%) vs 8 (3.2%) (RR, 0.78; 95% CI, 0.27-2.20; P = .79), and 28-day in-hospital death in 3 (1.2%) vs 10 (4.0%) (RR, 0.31; 95% CI, 0.09-1.11; P = .09). The most common adverse event reported was diarrhea (14 [5.8%] in the ivermectin group and 4 [1.6%] in the control group).
The upshot:
Conclusions and Relevance In this randomized clinical trial of high-risk patients with mild to moderate COVID-19, ivermectin treatment during early illness did not prevent progression to severe disease. The study findings do not support the use of ivermectin for patients with COVID-19.
The authors point out the limitations of the work in this portion of the discussion.
In this randomized clinical trial of early ivermectin treatment for adults with mild to moderate COVID-19 and comorbidities, we found no evidence that ivermectin was efficacious in reducing the risk of severe disease. Our findings are consistent with the results of the IVERCOR-COVID19 trial,17 which found that ivermectin was ineffective in reducing the risk of hospitalization.
Prior randomized clinical trials of ivermectin treatment for patients with COVID-19 and with 400 or more patients enrolled focused on outpatients.16,17 In contrast, the patients in our trial were hospitalized, which permitted the observed administration of ivermectin with a high adherence rate. Furthermore, we used clearly defined criteria for ascertaining progression to severe disease.
The pharmacokinetics of ivermectin for treating COVID-19 has been a contentious issue. The plasma inhibitory concentrations of ivermectin for SARS-CoV-2 are high; thus, establishing an effective ivermectin dose regimen without causing toxic effects in patients is difficult.27,28 The dose regimens that produced favorable results against COVID-19 ranged from a 0.2-mg/kg single dose to 0.6 mg/kg/d for 5 days29–32; a concentration-dependent antiviral effect was demonstrated by Krolewiecki et al.29 Pharmacokinetic studies have suggested that a single dose of up to 120 mg of ivermectin can be safe and well tolerated.33 Considering the peak of SARS-CoV-2 viral load during the first week of illness and its prolongation in severe disease,34 our trial used an ivermectin dose of 0.4 mg/kg of body weight daily for 5 days. The notably higher incidence of AEs [“adverse effects”] in the ivermectin group raises concerns about the use of this drug outside of trial settings and without medical supervision.
Our study has limitations. First, the open-label trial design might contribute to the underreporting of adverse events in the control group while overestimating the drug effects of ivermectin. Second, our study was not designed to assess the effects of ivermectin on mortality from COVID-19. Finally, the generalizability of our findings may be limited by the older study population, although younger and healthier individuals with low risk of severe disease are less likely to benefit from specific COVID-19 treatments.
The placebos were not given. The study didn't assess the chance of getting infections when you take ivermectin, or of being hospitalized if you do, though other work has suggested no effect of ivermectin on either of these.
I was prepared to admit that my criticism of ivermectin was wrong, but I wanted to know whether or not getting the jabs was better than ivermectin.
We will have a pretty solid conclusion once more studies come out. I bet any reader $100 that it will show that ivermectin is not a substitute for vaccination or the other new drugs that are being used to relieve symptoms.
The question now is whether people like Joe Rogan will admit that ivermectin has no effect. Richard Dawkins has emphasized the importance of scientists admitting when they are wrong. Admissions like this move science along faster than waiting for a generation to die off and be replaced by others who have different ideas. I haven't been wrong about ivermectin yet, but when I see a study showing it's more effective than vaccines in keeping you out of the hospital, or alive, I would like to think I'm wrong. Will the Weinsteins say something?
I don't think we will see a lot of hemming and hawing frothe Quacksters.
The reason I'm so focused on this is that people who tout quack remedies can do harm. It is worse if they push the quackery while wearing the mantle of science.
Stay away from the Damascus area.
h/t: Alex.
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